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§1904.6 (b)
* Determination of new cases
1904
Recording & Reporting Occu-
pational Injuries and Illnesses
11
(3)
How do I handle a case if it is not obvious whether the pre-
cipitating event or exposure occurred in the work environ-
ment or occurred away from work?
In these situations, you
must evaluate the employee's work duties and environment
to decide whether or not one or more events or exposures in
the work environment either caused or contributed to the
resulting condition or significantly aggravated a pre-existing
condition.
[§1904.5(b)(3)]
(4)
How do I know if an event or exposure in the work envi-
ronment “significantly aggravated” a preexisting injury or ill-
ness?
A preexisting injury or illness has been significantly
aggravated, for purposes of OSHA injury and illness record-
keeping, when an event or exposure in the work environment
results in any of the following:
[§1904.5(b)(4)]
(i)
Death,
provided that the preexisting injury or illness would
likely not have resulted in death but for the occupational
event or exposure.
[§1904.5(b)(4)(i)]
(ii)
Loss of consciousness,
provided that the preexisting
injury or illness would likely not have resulted in loss of
consciousness but for the occupational event or expo-
sure.
[§1904.5(b)(4)(ii)]
(iii)
One or more days away from work, or
days of restricted
work, or days of job transfer that otherwise would not
have occurred but for the occupational event or exposure.
[§1904.5(b)(4)(iii)]
(iv)
Medical treatment in a case
where no medical treat-
ment was needed for the injury or illness before the work-
place event or exposure, or a change in medical
treatment was necessitated by the workplace event or
exposure.
[§1904.5(b)(4)(iv)]
(5)
Which injuries and illnesses are considered pre-existing con-
ditions?
An injury or illness is a preexisting condition if it
resulted solely from a non-work-related event or exposure
that occured outside the work environment.
[§1904.5(b)(5)]
(6)
How do I decide whether an injury or illness is work-
related if the employee is on travel status at the time the
injury or illness occurs?
Injuries and illnesses that occur
while an employee is on travel status are work-related if, at
the time of the injury or illness, the employee was engaged in
work activities “in the interest of the employer.” Examples of
such activities include travel to and from customer contacts,
conducting job tasks, and entertaining or being entertained to
transact, discuss, or promote business (work-related enter-
tainment includes only entertainment activities being
engaged in at the direction of the employer).
Injuries or illnesses that occur when the employee is on travel
status do not have to be recorded if they meet one of the
exceptions listed below.
[§1904.5(b)(6)]
(7)
How do I decide if a case is work-related when the employee is
working at home?
Injuries and illnesses that occur while an
employee is working at home, including work in a home office,
will be considered work-related if the injury or illness occurs while
the employee is performing work for pay or compensation in the
home, and the injury or illness is directly related to the perfor-
mance of work rather than to the general home environment or
setting. For example, if an employee drops a box of work docu-
ments and injures his or her foot, the case is considered work-
related. If an employee's fingernail is punctured by a needle from
a sewing machine used to perform garment work at home,
becomes infected and requires medical treatment, the injury is
considered work-related. If an employee is injured because he or
she trips on the family dog while rushing to answer a work phone
call, the case is not considered work-related. If an employee
working at home is electrocuted because of faulty home wiring,
the injury is not considered work-related.
[§1904.5(b)(7)]
§1904.6
Determination of new cases
(a)
Basic requirement.
You must consider an injury or illness to
be a “new case” if:
[§1904.6(a)]
(1)
The employee has not previously experienced a
recorded
injury or illness of the same type that affects the same part of
the body, or
[§1904.6(a)(1)]
(2)
The employee previously experienced a
recorded injury or ill-
ness of the same type that affected the same part of the body
but had recovered completely (all signs and symptoms had
disappeared) from the previous injury or illness and an event
or exposure in the work environment caused the signs or
symptoms to reappear.
[§1904.6(a)(2)]
(b) Implementation —
[§1904.6(b)]
(1)
When an employee experiences the signs or symptoms of a
chronic work-related illness, do I need to consider each recur-
rence of signs or symptoms to be a new case?
No, for occupa-
tional illnesses where the signs or symptoms may recur or con-
tinue in the absence of an exposure in the workplace, the case
must only be recorded once. Examples may include occupa-
tional cancer, asbestosis, byssinosis and silicosis.
[§1904.6(b)(1)]
(2)
When an employee experiences the signs or symptoms of an
injury or illness
as a result of an event or exposure in the work-
place, such as an episode of occupational asthma, must I treat
the episode as a new case? Yes, because the episode or
recurrence was caused by an event or exposure in the work-
place, the incident must be treated as a new case.
[§1904.6(b)(2)]
(3)
May I rely on a physician or other licensed health care profes-
sional to determine whether a case is a new case or a recurrence
of an old case?
You are not required to seek the advice of a phy-
sician or other licensed health care professional. However, if you
do seek such advice, you must follow the physician or other
licensed health care professional's recommendation about
whether the case is a new case or a recurrence. If you receive
recommendations from two or more physicians or other licensed
health care professionals, you must make a decision as to which
recommendation is the most authoritative (best documented, best
reasoned, or most authoritative), and record the case based upon
that recommendation.
[§1904.6(b)(3)]
(iii)
The injury or illness results solely from voluntary participation in a wellness
program or in a medical, fitness, or recreational activity such as blood
donation, physical examination, flu shot, exercise class, racquetball, or
baseball.
(iv)
The injury or illness is solely the result of an employee eating, drinking, or
preparing food or drink for personal consumption (whether bought on the
employer's premises or brought in). For example, if the employee is injured
by choking on a sandwich while in the employer's establishment, the case
would not be considered work-related.
Note:
If the employee is made ill by ingesting food contaminated by
workplace contaminants (such as lead), or gets food poisoning from food
supplied by the employer, the case would be considered work-related.
(v)
The injury or illness is solely the result of an employee doing personal tasks
(unrelated to their employment) at the establishment outside of the
employee's assigned working hours.
(vi)
The injury or illness is solely the result of personal grooming, self
medication for a non-work-related condition, or is intentionally self-inflicted.
(vii)
The injury or illness is caused by a motor vehicle accident and occurs on a
company parking lot or company access road while the employee is
commuting to or from work.
(viii)
The illness is the common cold or flu (Note: contagious diseases such as
tuberculosis, brucellosis, hepatitis A, or plague are considered work-related
if the employee is infected at work).
(ix)
The illness is a mental illness. Mental illness will not be considered work-
related unless the employee voluntarily provides the employer with an
opinion from a physician or other licensed health care professional with
appropriate training and experience (psychiatrist, psychologist, psychiatric
nurse practitioner, etc.) stating that the employee has a mental illness that
is work-related.
(continued)
1904.5(b)(2) You are not required to record injuries and illnesses if . . .
1904.5 (b)(6) If the employee
has . . .
You may use the following to determine
if an injury or illness is work-related
(i)
checked into a
hotel or motel for
one or more days
When a traveling employee checks into a hotel,
motel, or into an other temporary residence, he or
she establishes a “home away from home.” You
must evaluate the employee's activities after he or
she checks into the hotel, motel, or other
temporary residence for their work-relatedness in
the same manner as you evaluate the activities of
a non- traveling employee. When the employee
checks into the temporary residence, he or she is
considered to have left the work environment.
When the employee begins work each day, he or
she re-enters the work environment. If the
employee has established a “home away from
home” and is reporting to a fixed worksite each
day, you also do not consider injuries or illnesses
work-related if they occur while the employee is
commuting between the temporary residence and
the job location.
(ii)
taken a detour for
personal reasons
Injuries or illnesses are not considered work-related
if they occur while the employee is on a personal
detour from a reasonably direct route of travel (e.g.,
has taken a side trip for personal reasons).